Objective:To investigate the clinical features of nontuberculous mycobacteria (NTM) disease patients with positive anti-interferon γ (IFN-γ) autoantibody.Methods:Forty-three adult human immunodeficiency virus-uninfected patients with NTM disease hospitalized in Huashan Hospital, Fudan University and Jing′an Branch, Huashan Hospital, Fudan University from July 2021 to August 2023 were included. Clinical data and NTM strain information of the patients were collected. The plasma levels of anti-IFN-γ autoantibodies were detected by enzyme-linked immunosorbent assay, and the patients were divided into antibody positive group and antibody negative group. The clinical characteristics and laboratory examination results between the two groups were compared. The independent sample t test, Mann-Whitney U test and chi-square test were used for statistical analysis. Multivariate logistic regression analysis was used to determine the correlation factors of positive anti-IFN-γ autoantibodies. Results:Among the 43 patients, 13 cases (30.2%) were positive for anti-IFN-γ autoantibodies and 30 cases (69.8%) were negative. The proportions of patients with NTM disseminated infection (9/13 vs 30.0%(9/30))and combined bacterial infection (5/13 vs 6.7%(2/30)) in antibody positive group were both higher than those in antibody negative group, and the differences were both statistically significant ( χ2=5.74 and 6.73, respectively, both P<0.05). The white blood cell count, platelet count, the proportion of platelet count >350×10 9/L of antibody positive patients were all higher than those of antibody negative group, while the white sphere ratio was lower than that of antibody negative group, with statistical significance ( t=2.42, 3.02, χ2=9.77 and t=3.66, respectively, all P<0.05). Erythrocyte sedimentation rate, C-reactive protein, procalcitonin, globulin, immunoglobulin G, immunoglobulin A and immunoglobulin M in antibody positive patients were all higher than those in antibody negative group, and the differences were all statistically significant ( U=99.50, 112.00, 115.50, 61.50, 76.50, 99.00 and 83.00, respectively, all P<0.05). Mycobacterium abscessus complex (seven cases and 11 cases, respectively) and Mycobacterium avium complex (five cases and 13 cases, respectively) were the main isolated strains in antibody positive and antibody negative patients. Multivariate logistic regression analysis showed that combined with bacterial infection (odds ratio ( OR)=21.83, 95% confidence interval ( CI) 1.94 to 245.71), NTM disseminated infection ( OR=7.64, 95% CI 1.10 to 53.26), platelet count>350×10 9/L ( OR=14.31, 95% CI 1.91 to 107.04) were risk factors for anti-IFN-γ autoantibodies positive (all P<0.05). Conclusions:Patients with positive anti-IFN-γ autoantibodies have higher probability of having elevated levels of systemic inflammation. Anti-IFN-γ autoantibody test is recommended for patients with NTM disease who present with co-bacterial infection, NTM disseminated infection, or elevated platelet count (>350×10 9/L).

Objective To explore the mechanism of gene Nelin on the differentiation of vascular smooth muscle cells(VSMC).Methods Human VSMCs were stably infected with over-express lentiviral vector [Nelin-VSMC] and interference lentiviral vector [LV-Nelin-SiRNA-VSMC] by Western blotting and RT-PCR.The effect of Nelin expression on phenotypic transition of VSMCs was observed and the mechanism involved was explored.Results The Nelin-VSMC cells take on the contractile phenotype of long slender cells possessing hill-valley characteristics.Overexpression of Nelin can enhance SMoα-actin expression with the increase of total RhoA and nuclear serum response factor(SRF) expression.Treated with a selective Rho kinase inhibitor Y-27632,the expression of SMα-actin and nuclear SRF protein induced by Nelin was effectively reduced.Meanwhile,the opposite results were observed in the Nelin-depression VSMC.Conclusions Nelin can enhance the expression of SMα-actin and carry a pivotal role in the process of VSMCs differentiation and phenotype modulation by activating Rho and SRF.

Objectives To evaluate modified transthoracic esophageal transection (modified Walker's procedure) for management of postoperative rebleeding of portal hypertension.Methods Since 1983,we adopted modified Walker's operation to make low esophageal transection and transect intraabdominal recurrent varix of the coronary vein in the treatment of esophageal variceal rebleeding in portal hypertensive patients who had received previous surgeries aiming at portal hypertension.Results In 53 cases of postoperative rebleeding of portal hypertension,49 cases underwent elective operation with no mortality,4 cases received emergency surgery,one died post-operatively due to hepatic failure.The postoperative control rate of recurrent bleeding was 100％,and the overall postoperative mortality was 2％.The longest postoperative survival time was 24 years,and the 5-year survival rate was 77％.There were no postoperative recurrent hemorrhage and hepatic encephalopathy.Conclusions Modified transthoracic esophageal transection (modified Walker's procedure) is easy to perform,good at saving operative time,with a reliable immediate hemostatic effect and long-term control of variceal hemorrhage,hence is a effective remedy operative method for postoperative rebleeding of portal hypertensive patients after failed previous operations.

Objective To establish the quality standard for Shengxinfa Capsule. Methods TLC was used to identify Praeparata, Psoraleae Fructus and Gastrodiae Rhizoma in Shengxinfa Capsule, and 2,3,5,4’-the four-stilbene-2-O-β-D-glucoside was identified by HPLC. The column of Agilent TC-C18 (4.6 mm×250 mm, 5 μm) was used. The mobile phase was acetonitrile-water (15∶85). The flow was 1.0 mL/min and column temperature was 30 ℃. UV detecting wavelength was 320 nm. Results Praeparata, Psoraleae Fructus and Gastrodiae Rhizoma could be identified by TLC. The linear range of 2,3,5,4’-the four-stilbene-2-O-β-D-glucoside was in the range of 0.05-0.50 μg. The average recovery was 97.8% (RSD=0.39%). Conclusion The method is feasible and accurate. The quality of Shengxinfa Capsule can be controlled effectively with the established quality standard.

ObjectiveTo explore the relationship between the expression of smooth muscle 22 alpha ( SM22α),α-smooth muscle actin (α-SMA) and the development of varicose veins of the lower extremities. MethodsWe collected tissues of varicose saphenous vein in the experimental group,and what left over of normal saphenous vein tissues harvested for a coronary bypass operation ( control group).RT-PCR were applied to investigate the expression level of SM22αmRNA and immunohistochemical techniques were applied to investigate the expression level of SM22α and α-SMA protein in normal and varicose veins.ResultsThe expression level of SM22α mRNA in normal and abnormal veins was 0.2614 ±0.1168 and 0.5114 ± 0.1554 respectively ( t =5.020,P ＜ 0.01 ).The immunohistochemical staining showed that signals of SM22α and α-SMA protein existed in the cytoplasm of smooth muscle cells.The integrate optical density (IOD) of SM22α in normal and abnormal veins was 10 055 ± 3584 and 16 226 ± 3378 respectively ( t =4.991,P ＜ 0.01 ).The IOD of α-SMA in normal and abnormal veins was 9746 ± 3903 and 15 371 ± 4318 respectively (t =3.861,P ＜ 0.05 ). ConclusionsSM22α and α-SMA was down-regulated in varicose veins,indicating that the VSMC had transformed the typical contractile phenotype into the typical synthetic phenotype.Phenotype changes of VSMC further promote venous wall remodeling leading to the occurrence of varicose veins.

Objective To investigate the relationship between the 6-Keto-PGF1α,TXB2 and the endotheliosis and thrombosis of the new endomembrance on the prostheses seeded by CD34 stem cells.Method Twelve dogs were evenly divided into two groups; ePTFE prostheses and weaved Dacron prostheses implanted into the abdominal aorta(AA) and inferior vena cava (IVC).in each group, 4 dogs were implanted by prostheses seeded by CD34+ stem cells, 2 dogs were implanted prostheses treated by autogenous blood only as control.The peripheral blood was collected in preoperative and 3 ,7,14,30,60 days postoperation.light and electron microscopy were applied to observe the endotheliosis and thrombosis of the new endomembrance when harvesting all the prostheses in the 60 days.Result The platelet, 6-Keto-PG F1α,TXB2 and P/T in experimental group was significantly different compared with control group.The new endomembrane in control group was significantly thickener than the experimental group.Conclusions CD34+ stem cell inhibits PGF1α and P/T ratio decrease, restrains TXB2 and platelet excessively rise, prevents intimal hyperplasia and thrombosis in a CD34+ stem cells seeded blood vessel prostheses.

Objective To investigate the distribution of acquired carbapenemases in carbapenemresistant strains of Klebsiella pneumoniae, and explore its role in epidemiology of nosocomial infection. Methods From November 2008 to March 2009, twenty clinical isolates of carbapenem-resistant Klebsiella pneumoniae were collected from children hospitalized in Wuhan children's hospital. MICs of antibiotics were tested by DNA of Klebsiella pneumoniae. Modified Hodge test was used to screen strains producing carbapenemases,combined imipenem(IPM)-EDTA , meropenem(MEM)- EDTA and ceftazidime(CAZ) - EDTA double-disk synergy test (DDST) were used to detect metallo-β-lactamase-producing. PCR amplification of the carbapenemase and integrase genes, and sequencing were performed. Plasmid conjugation transfer experiments and Southern hybridization were applied to study the mode of drug resistance transmission. Results Four types of Klebsiella pneumoniae were detected by PFGE, type A consisted of 5 strains, including 3 strains of type Al and 2 strains of type A2), type B (2 strains), type C (12strains) and type D (1 strain). Type A and C were the main drug resistant clones. Eight strains of Klebsiella pneumoniae carried both KPC-2 and IMP-4 genes, 10 strains carried IMP-4 gene, 2 strains carried KPC-2 gene. None of NDM-1 ,GIM, SPM, SIM, OXA-23, and VIM carbapenemase genes was detected in 20 isolates. All of 20 isolates carried lntl which were found to be located on bacterial chromosome by Southern blot. Conclusions KPC-2and IMP-4 genes are the major carbapenemase genes in Klebsiella pneumoniae isolated in Wuhan.Transmission of drug resistance is mainly through vertical transmission of type C resistant clone and horizontal transmission of Intl on bacteria chromosome.

Objective To investigate the molecular epidemiology of CRAB isolated from children in wuhan. Methods Forty non-repetitive strains of CRAB were collected from hospitalized children of emergency department, neonatal medicine, cardiothoracic surgery, bone surgery, respiratory medicine and renal medicine in Wuhan children's hospital during December 2008 and May 2009. MIC values were PFGE; KPC, IMP, GIM, SPM, SIM, OXA-23, VIM genes and integrase gene were amplified by PCR and then sequenced to confirm the genotypes.; Plasmid conjugation experiment was used to study the transfer method of bacterial resistance and southern blot hybridization was used to target the resistance genes. Results Susceptible rates of 40 strains to gentamicin, tobramycin, amikacin, ciprofloxacin, levofloxacin, trimoxazole were 20%, 5%, 93%, 93%, 95%, and 23% respectively. Eleven types of clone were detected by PFGE,including 29 strains of type A clone, 2 strains of type B clone, and 1 strain for each type of C to K clone. Eleven isolates produced both IMP-4 and OXA-23 carbapemase. Twenty-six isolates only possessed OXA-23 carbapemase. Thirty-six strains carried class Ⅰ integron. The results of southern blot hybridization showed that Intl, IMP-4 and OXA-23 type were located on chromosome. Conclusions Type A clone of CRAB is the most common. OXA-23 and IMP-4 type are the major acquired carbapemases, especially the OXA-23 is the most common type. The horizontal transmission of OXA-23 and IMP-4 gene mediated by Int1 and the spread of type A resistant clone is the major way of the spread of carbapenem-resistant Acinetobacter baumannii in the region.

The characteristics of cardiovascular autonomic nerve system(ANS) modulation during exposure to three different altitudes were compared by time domain, spectral and nonlinear analysis of short-(5 minutes)term heart rate variability (HRV). The standard deviation of all RR intervals (SDNN), the square root of the mean squared differences of successive RR intervals (rMSSD), the percentage of successive interval differences >50 ms (PNN50), low frequency (LF), high frequency power (HF), and total power (TP) at 2800 m were slightly higher than those at 1856 m, but the differences were non-significant statistically. SDNN, rMSSD, LF and HF at 3040 m were significantly lower than those at 1856 m and 2800 m. These results show that parasympathetic nerve activity decreases significantly, and ANS modulation is blunted after exposure to higher altitude. This kind of change of ANS may contribute to further elucidate pathophysiology in body after exposure to high altitude.
Adult ; Altitude ; Autonomic Nervous System ; physiology ; Electrocardiography ; Heart Rate ; physiology ; Humans ; Male

To evaluate the effect of aerobic and anaerobic endurance training the regulating the function of autonomic nervous system, in order to provide scientific basis for optimizing the project of physical fitness training. Fourty-one healthy young men were randomly divided into aerobic and anaerobic endurance training groups. The training period was 8 weeks. Pre-exercise, 4 weeks and 8 weeks after trained, HRV were measured compared with pre-exercise. The autonomic balance in aerobic endurance group had an increasing parasympathetic activity (HF, HFnu, RMSSD, PNN50, all P was < 0.05) and relatively decreasing sympathetic activity (LFnu). This group showed a parasympathetic predominance (LF/HF) and increase of HRV. While in the anaerobic group there was a relative stabilization with the function of autonomic nervous system. The present study shows that the effect of aerobic and anaerobic endurance training on the autonomic nervous system depends on its intensity. Proper intensity of anaerobic endurance training may be beneficial to improve the adaptability of human body for circumstances as aerobic endurance training.
Adolescent ; Adult ; Autonomic Nervous System ; physiology ; Electrocardiography ; Exercise ; physiology ; Heart Rate ; physiology ; Humans ; Male ; Physical Endurance ; physiology ; Running ; physiology ; Sympathetic Nervous System ; physiology ; Vagus Nerve ; physiology